Related Experiment Video
Updated: Nov 10, 2025
Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice
Published on: April 13, 2015
Anatomical-functional discordance between quantitative coronary angiography and diastolic pressure ratio during
Shun Nakamura1, Taishi Yonetsu1,2, Masahiro Hoshino3
1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Japan.
Insights
Anatomical-functional discordance between quantitative coronary angiography (QCA) and diastolic pressure ratio (dPRWFP) is common. Predictors for this mismatch differ from those of QCA-FFR discordance, highlighting unique insights into coronary lesion assessment.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Diagnostic imaging
Background:
- Discrepancies between anatomical stenosis (QCA-DS) and physiological significance (dPRWFP) are common in clinical practice.
- While QCA-FFR discordance is well-studied, predictors of QCA-dPRWFP discordance remain less understood.
Purpose of the Study:
- To identify predictors of anatomical-functional discordance between QCA-derived diameter stenosis (QCA-DS) and dPRWFP.
- To compare predictors of QCA-dPRWFP discordance with those of QCA-FFR discordance.
Main Methods:
- Analysis of 647 intermediate coronary lesions (QCA-DS 30-70%) in 502 patients.
- Determination of predictors for QCA-dPRWFP mismatch (QCA-DS >50%, dPRWFP >0.89) and reverse mismatch (QCA-DS ≤50%, dPRWFP ≤0.89).
- FFR ≤0.80 defined as positive FFR; predictors of QCA-FFR discordance also analyzed.
Main Results:
- QCA-dPRWFP mismatch and reverse mismatch occurred in 27.5% and 17.6% of cases.
- Predictors for mismatch included non-LAD lesions, large minimal lumen diameter, low heart rate, and high CFR.
- Predictors for reverse mismatch included LAD lesions, non-culprit ACS lesions, long lesion length, low LVEF, low CFR, and low IMR.
Conclusions:
- Anatomical-functional discordance between QCA and dPRWFP is not uncommon.
- Predictors for QCA-dPRWFP discordance differ significantly from those for QCA-FFR discordance.
- These findings emphasize distinct factors influencing resting vs. hyperemic indices in coronary lesion assessment.
Objectives:
This study sought to determine the predictors of anatomical-functional discordance between quantitative coronary angiography (QCA) derived diameter stenosis (QCA-DS) and diastolic pressure ratio during wave-free period (dPRWFP ).
Background:
The discrepancy between angiographical stenosis and physiological significance is frequently experienced in clinical practice. Although the anatomical-functional discordance between angiography and fractional flow reserve (FFR) has been intensively investigated, that of resting index including dPRWFP remains to be elucidated.
Methods:
In a total of 647 angiographically intermediate lesions with QCA-DS between 30 and 70% in 502 patients, predictors of having QCA-DS >50% and dPRWFP > 0.89 (QCA-dPRWFP mismatch), and those of having QCA-DS ≤50% and dPRWFP ≤ 0.89 (QCA-dPRWFP reverse mismatch) were determined. FFR ≤0.80 was defined as positive FFR and the predictors of QCA-FFR discordance were determined as well.
Results:
QCA-dPRWFP mismatch and reverse mismatch were observed in 27.5 and 17.6% of cases, respectively. The predictors of mismatch were non-left anterior descending artery (LAD) lesion, large minimal lumen diameter, low baseline heart rate, and high coronary flow reserve (CFR), while those of reverse mismatch were LAD lesion, non-culprit lesion of acute coronary syndrome, long lesion length, low left ventricular ejection fraction, and low CFR and index of microcirculatory resistance. Age, sex, and the culprit vessel of prior myocardial infarction were not significant determinants of QCA-dPRWFP discordance unlike QCA-FFR discordance derived from the same cohort.
Conclusions:
Anatomical-functional discordance between angiography and dPRWFP was not uncommon. Predictors differed between QCA-dPRWFP discordance and QCA-FFR discordance.
More Related Videos
11:04Quantification of Global Diastolic Function by Kinematic Modeling-based Analysis of Transmitral Flow via the Parametrized Diastolic Filling Formalism
Published on: September 1, 2014
11:13Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging
Published on: May 24, 2021